Healthcare Provider Details

I. General information

NPI: 1316305030
Provider Name (Legal Business Name): COASTAL HAND & OCCUPATIONAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2016
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MARY AVE SUITE 1
NIPOMO CA
93444-7820
US

IV. Provider business mailing address

201 N COLLEGE DR SUITE 203
SANTA MARIA CA
93454-4614
US

V. Phone/Fax

Practice location:
  • Phone: 805-929-3230
  • Fax: 805-929-3232
Mailing address:
  • Phone: 805-922-1724
  • Fax: 805-922-2765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DONALD T CALE
Title or Position: OWNDER
Credential: PT
Phone: 805-922-1724